A 35-year-old male presented with difficulty sleeping for more than 25 years. He described lying in bed tossing and turning for 1–2 h before finally falling asleep, and frequently waking up not feeling refreshed in the morning. He further stated that as long as he could remember he had been shaking his left leg to rock himself to sleep or while sitting for a long period of time. At night, he often had to wrap his left leg in multiple sheets to prevent it from moving. The shaking was relieved by walking and was not associated with any pain, tingling, cramping or creepy crawly sensation. The patient had a history of snoring, worse on his back, but denied being aware of any apneic episodes or arousals due to abnormal breathing events. His Epworth sleepiness scale (ESS) score was 8 out of a possible 24 points, and he had no history suggestive of rapid eye movement (REM) sleep behavior disorder (RBD), cataplexy, narcolepsy, sleep paralysis, bruxism or somnambulism. He was not taking any medications and did not have any medical problems. The patient had a body mass index (BMI) of 19.61 kg/m. Physical examination was significant for mild retrognathia (normal cephalometric X-rays), and Grade 2 Mallampati airway with no tonsillar enlargement. The rest of the examination was normal, and the basic laboratory work-up and ferritin levels were within normal limits.